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      Risk-taking and decision-making in youth: Relationships to addiction vulnerability

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          Abstract

          Background

          Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use.

          Methods

          Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationships to addiction vulnerability in youth.

          Results

          Decision-making and risk-taking behaviors involve brain areas that undergo developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking.

          Conclusions

          Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in addictive behaviors.

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          Most cited references 75

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          Delay of gratification in children

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            The adolescent brain.

            Adolescence is a developmental period characterized by suboptimal decisions and actions that give rise to an increased incidence of unintentional injuries and violence, alcohol and drug abuse, unintended pregnancy and sexually transmitted diseases. Traditional neurobiological and cognitive explanations for adolescent behavior have failed to account for the nonlinear changes in behavior observed during adolescence, relative to childhood and adulthood. This review provides a biologically plausible conceptualization of the neural mechanisms underlying these nonlinear changes in behavior, as a heightened responsiveness to incentives while impulse control is still relatively immature during this period. Recent human imaging and animal studies provide a biological basis for this view, suggesting differential development of limbic reward systems relative to top-down control systems during adolescence relative to childhood and adulthood. This developmental pattern may be exacerbated in those adolescents with a predisposition toward risk-taking, increasing the risk for poor outcomes.
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              Introduction to behavioral addictions.

              Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions. Inform the discussion on the relationship between psychoactive substance and behavioral addictions. We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
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                Author and article information

                Journal
                2006
                122266
                Journal of Behavioral Addictions
                JBA
                Akadémiai Kiadó, co-published with Springer Science+Business Media B.V., Formerly Kluwer Academic Publishers B.V.
                2062-5871
                2063-5303
                1 March 2013
                : 2
                : 1
                : 1-9
                Affiliations
                [ 1 ] Department of Psychiatry, VA Connecticut Healthcare/Yale University School of Medicine, West Haven, CT, USA
                [ 2 ] Child Study Center, Yale University School of Medicine, New Haven, CT, USA
                [ 3 ] Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
                [ 4 ] Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
                [ 5 ] Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, Room S-104, 34 Park Street, New Haven, CT, USA
                Author notes
                [* ] +1 203-974-7356, +1 203-974-7366, marc.potenza@ 123456yale.edu
                Article
                1
                10.1556/jba.2.2013.1.1
                © 2013 The Author(s)

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                Product
                Self URI (journal page): https://akademiai.com/loi/2006

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